Individual provider Active NPI

Theodore Loewenthal, MD

  • Gastroenterology Physician
  • Bloomfield, CT
National Provider Identifier
1780788398
Registry record updated Apr 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
024561 Issued in CT
Practice address
6 Northwestern Dr
Suite 302
Bloomfield, CT 06002-3463
Phone
(860) 243-5600
Fax
(860) 243-3047
NPI assigned
Sep 12, 2006
Last updated
Apr 29, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 024561 CT Primary

Addresses

Primary practice location

6 Northwestern Dr
Suite 302
Bloomfield, CT 06002-3463

Mailing address

2139 Silas Deane Hwy
Rocky Hill, CT 06067-2336
Phone (860) 257-4131

Other identifiers 1

IdentifierTypeStateIssuer
001245612MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
024561CTMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Litchfield County Gastroenterology Associates, LLC Gastroenterology PastSince Apr 1, 2007 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1158019200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1304035200000",
    "number": "1780788398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2139 SILAS DEANE HWY",
            "city": "ROCKY HILL",
            "state": "CT",
            "postal_code": "060672336",
            "telephone_number": "860-257-4131",
            "fax_number": "860-257-4519"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 NORTHWESTERN DR",
            "address_2": "SUITE 302",
            "city": "BLOOMFIELD",
            "state": "CT",
            "postal_code": "060023463",
            "telephone_number": "860-243-5600",
            "fax_number": "860-243-3047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOEWENTHAL",
        "first_name": "THEODORE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-12",
        "last_updated": "2011-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "024561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001245612",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.